Which medications are under investigation for the treatment of persistent pulmonary hypertension of the newborn (PPHN)?

Updated: Sep 03, 2019
  • Author: Kate A Tauber, MD; Chief Editor: Howard S Weber, MD, FSCAI  more...
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Answer

Answer

Studies have shown that Rho A/Rho kinase activation causes pulmonary vasoconstriction and promotes pathogenic vascular remodeling. Previous investigators have demonstrated that inhibition of the activity of Rho A/Rho kinases using the Rho kinase inhibitor fasudil has beneficial effects on the pulmonary vasculature on different animal models of pulmonary hypertension. [63]

Magnesium sulfate promotes vasodilatation by antagonizing the entry of calcium ions into the smooth muscle cells. [64] However, its pulmonary vasodilator properties have not been studied in the adult or pediatric population.

Combination therapy offers a greater option to enhance pulmonary vasodilatation compared with monotherapy. For example, iNO can work synergistically with PDE-5 inhibitors to increase cGMP levels; prostacyclin (PGI2) (which enhances c-AMP) can work synergistically with iNO (which enhances c-GMP); endothelin receptors antagonists can work synergistically with iNO.


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